Article Figures & Data
Figures
- FIG. 1.
Laboratory markers over time in PML survivors and nonsurvivors: HIV viral load (copies/ml), CD4+ T-cell count (cells/μl), JCV- and CMV-specific cellular immune responses (gamma interferon SFU/million PBMCs), and JCV-specific IgG and IgM antibody activities (OD492).
- FIG. 2.
Cellular and humoral immunities in PML cases at the time of PML diagnosis and in matched controls. The P values correspond to comparisons of cases versus controls in PML survivors and nonsurvivors separately with adjustment for matching as described in Materials and Methods. The box plots of data are drawn in gray, with individual measurements shown as black dots.
Tables
- TABLE 1.
Baseline characteristics for 29 PML cases
Characteristicsa Summary statisticb Pc All patients (n = 29) Survivors (n = 18) Nonsurvivors (n = 11) Age (yr) 39 (36, 45) 37 (34, 44) 42 (39, 45) 0.13 Female gender 5 (17) 2 (11) 3 (27) 0.34 PML diagnosis Definitive 4 (14) 2 (11) 2 (18) 0.09 Laboratory confirmed 10 (34) 4 (22) 6 (55) Possible 15 (52) 12 (67) 3 (27) Yr since first positive HIV test 8.20 (2.72, 11.34) 7.10 (0.51, 9.14) 10.81 (8.30,13.19) 0.03 CD4 cell count (cells/μl) 102 (35, 152) 119 (82, 192) 35 (18, 107) 0.02 CD8 cell count (cells/μl) 700 (455, 1137) 698 (546, 1030) 700 (425, 1168) 0.74 HIV viral load (log10 copies/ml) 4.18 (2.62, 5.28) 3.88 (2.62, 4.88) 4.98 (2.79, 5.41) 0.22 Prior AIDS-defining conditions 12 (41) 9 (50) 3 (27) 0.27 cART status at PML diagnosis cART naïve 10 (34) 7 (39) 3 (27) 0.45 cART treated 10 (34) 7 (39) 3 (27) cART interrupted 9 (31) 4 (22) 5 (45) cART (re)initiated within 3 mo of PML diagnosis In cART-naïve patients 7/10 (70) 6/7 (86) 1/3 (33) 0.10 In cART-pretreated patients 4/9 (44) 3/4 (75) 1/5 (20) - TABLE 2.
Comparison of PML cases and their matched controlsa
Parameter All PML patients and their controls Patients with laboratory-confirmed or definitive diagnosis and their controls Odds ratio (95% CI) P Odds ratio (95% CI) P JCV-specific cellular immune response (estimates by 10-fold higher of parameter +1) All patients 0.77 (0.36, 1.62) 0.48 0.20 (0.03, 0.68) 0.008 Survivors 1.19 (0.48, 3.05) 0.71 0.50 (0.09, 2.08) 0.34 Nonsurvivors 0.29 (0.05, 1.13) 0.08 0.03 (0.00, 0.46) 0.004 CMV-specific cellular immune response (estimates by 10-fold higher of parameter +1) All patients 0.85 (0.46, 1.54) 0.60 0.56 (0.19, 1.47) 0.24 Survivors 0.87 (0.35, 2.07) 0.75 1.41 (0.18, 11.50) 0.73 Nonsurvivors 0.85 (0.38, 1.88) 0.68 0.44 (0.11, 1.30) 0.14 JCV VLP IgG response (estimates by 2-fold-higher parameter value) All patients 1.31 (1.01,1.75) 0.04 1.14 (0.83, 1.63) 0.42 Survivorsb 1.73 (1.19, 2.70) 0.003 1.46 (0.91, 2.94) 0.13 Nonsurvivors 0.86 (0.53, 1.34) 0.50 0.88 (0.52, 1.43) 0.62 JCV VLP IgM response (estimates by 2-fold-higher parameter value) All patients 1.45 (0.91, 2.40) 0.12 2.39 (0.99, 6.24) 0.053 Survivors 1.44 (0.87,2.48) 0.15 3.08 (1.02, 11.11) 0.047 Nonsurvivors 1.48 (0.41, 5.32) 0.53 1.51 (0.35, 6.65) 0.56 ↵ a Odds of developing PML based on cellular and humoral immunity at time zero in all patients and in PML survivors and nonsurvivors (and their matched controls) separately. The results are based on logistic regression using Firth's bias reduction adjusted for matching. CI, confidence interval.
↵ b If results are based on non-log-transformed JCV VLP IgG response instead, which is equally sensible based on the data, the results for survivors are significant both in all survivors (P = 0.001) and in survivors with laboratory-confirmed or definitive diagnosis and their controls (P = 0.03).
- TABLE 3.
Logistic survival for estimating the effects of cellular and humoral immunity at the time of PML diagnosis on 1-year survivala
Parameter All PML patients Patients with laboratory-confirmed or definitive diagnosis Odds ratio (95% CI) P Odds ratio (95% CI) P JCV-specific cellular immune response (estimates by 10-fold higher of parameter +1) Unadjusted 0.36 (0.09, 1.20) 0.10 0.06 (0.00, 0.62) 0.02 Adjusted for CD4 cell count 0.45 (0.11, 1.57) 0.21 0.11 (0.00, 1.56) 0.11 CMV-specific cellular immune response (estimates by 10-fold higher of parameter +1) Unadjusted 1.00 (0.46, 2.19) 1.00 0.67 (0.12, 2.00) 0.49 Adjusted for CD4 cell count 1.23 (0.53, 3.04) 0.63 1.15 (0.13, 19.97) 0.88 JCV VLP IgG response (estimates by 2-fold-higher parameter value) Unadjusted 0.51 (0.27, 0.84) 0.007 0.62 (0.30, 1.08) 0.09 Adjusted for CD4 cell count 0.54 (0.28, 0.90) 0.02 0.67 (0.28, 1.31) 0.24 JCV VLP IgM response (estimates by 2-fold-higher parameter value) Unadjusted 0.84 (0.34, 1.49) 0.58 0.46 (0.12, 1.39) 0.17 Adjusted for CD4 cell count 0.88 (0.36, 1.57) 0.68 0.29 (0.00, 1.30) 0.12 ↵ a Univariate analyses and analyses adjusted for CD4 cell counts based on logistic regression using Firth's bias reduction. CI, confidence interval.
